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Cost-effectiveness of gastroscopy.

P Bytzer1

  • 1Department of Medical Gastroenterology, Glostrup University Hospital, Denmark. peter.bytzer@dadlnet.dk

Italian Journal of Gastroenterology and Hepatology
|March 24, 2000
PubMed
Summary

Gastroscopy in dyspepsia management is debated. Initial endoscopy may be cost-effective in Europe, but a test-and-eradicate strategy for Helicobacter pylori is promising for younger patients.

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Area of Science:

  • Health economics
  • Gastroenterology
  • Decision analysis

Background:

  • The role of gastroscopy in dyspepsia management is a significant topic in health economics.
  • Cost-effectiveness analyses are crucial for evaluating diagnostic strategies in gastroenterology.
  • Comparing gastroscopy to alternative strategies like empirical treatment or Helicobacter pylori testing is essential.

Purpose of the Study:

  • To review the cost-effectiveness of gastroscopy in managing dyspeptic patients.
  • To compare gastroscopy with deferred referral strategies, including empirical antisecretory medication and non-invasive Helicobacter pylori testing.
  • To address the variability in cost estimates and the lack of uniformity in cost-effectiveness analyses.

Main Methods:

  • Review of existing cost-effectiveness analyses and decision analyses.
  • Comparison of gastroscopy with empirical acid inhibition and test-and-scope strategies.
  • Evaluation of a test-and-eradicate strategy for young dyspeptic patients without warning symptoms.

Main Results:

  • Cost estimates for gastroscopy vary widely, particularly between European countries and the US.
  • Initial endoscopy appears cost-effective compared to empirical acid inhibition and test-and-scope strategies, especially in Europe.
  • A test-and-eradicate strategy shows promise for cost-effectiveness in younger dyspeptic patients compared to early endoscopy.

Conclusions:

  • Variability in cost and outcome reporting hinders direct comparison of cost-effectiveness studies.
  • Initial endoscopy may be a cost-effective approach for dyspepsia management in Europe.
  • A test-and-eradicate strategy could reduce endoscopies without adverse effects, but long-term monitoring is needed due to changing H. pylori epidemiology.

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